1. Field of the Invention
The present invention relates generally to the biofeedback training using an automatic system for operant conditioning, and more particularly to a medical instrument to be worn by patients with scoliosis (curvature of the spine).
2. Description of the Related Art
The present invention relates, in its broad aspects, to the field in experimental psychology known as operant conditioning. An article in this field is "Shaping By Automated Tracking Of An Arbitrary Operant Response", by Pear and Legris, Journ. Experimental Analysis of Behavior, No. 2, March 1987, pgs. 241-247, which describes the training of pigeons to peck at a target by rewarding the pigeons with food when they pecked at the target. The process is called "shaping" of "operant responses" because closer approximations to the target are rewarded ("reinforced"). The subject must continually improve in order to gain the reward. In the Pear-Legris article the size of the target was made smaller, which made the pigeons improve in finding the target and the birds' movements were recorded using two TV-cameras connected to a microcomputer. The article concludes that "current knowledge of what happens during shaping is primarily qualitative and not easily communicated . . . "
An improved and microcomputer controlled automatic operant shaping process and system is envisioned to be applicable to various fields. For example, in the field of human physical rehabilitation training involving the skeleton-muscle system, it may be used to correct the walking gait of stroke patients. Another use may be as a respiration trainer for post-surgical patients who fail to breathe deeply enough following their operation. Other examples include its employment as a type of biological feedback to modify visceral functions, such as blood pressure and sensory motor rhythms. Outside of the field of medicine, operant response conditioning may be employed to improve sports performance and "small motor" tasks, i.e., hand tasks, such as keyboard entry learning.
The particular application of the present invention, discussed as an embodiment, is the treatment of idiopathic scoliosis, which is the pathologic lateral curvature of the spine. Idiopathic scoliosis, it is reported, affects 2-4% of adolescents, 80% of whom are female, and at least 6% of those affected have a truncal deformity which grows worse throughout adolescence. The usual treatment is for the patient to wear a brace, such as the Milwaukee brace, which fits around the chest and neck. The brace should be worn 23 hours a day, 7 days a week, from 2-4 years. Young girls hate wearing such braces, and often refuse or neglect to do so. Even those who manage to wear braces suffer. Sometimes the brace, in restricting truncal motion, may cause the trunk muscles to weaken or atrophy. The brace's constant pressure causes deformation of the rib cage or soft tissue on which the brace rests.
U.S. Pat. No. 4,055,168 to Neal Miller and Barry Dworkin, assigned to Rockefeller University, and the article "Behavioral Method For the Treatment of Idiopathic Scoliosis", by Dworkin, Miller et al, Proc. Natl. Acad. Sci., Vol. 82, pgs. 2493-2497, April 1985, both incorporated by reference, describe a posture training device for the treatment of idiopathic scoliosis. In that device one cable (body harness cord) extends around the chest of the patient to monitor respiration and a second cable extends around the longitudinal axis of the body from the pubis to the scalpula. Both cables are connected at their ends, in one embodiment, to slidable plates and in another embodiment to rotary potentiometers.
Although that posture training device was relatively successful on groups of test patients, compared to the treatment using braces, the device has not been commercially produced.